“Told You So, Obamacare’s Back”: By Next Fall, HealthCare.gov Is Going To Be A Net Plus For President Obama And Democrats
If one looks just at the raw, bottom-line number the Department of Health and Human Services released Wednesday—365,000 citizens enrolled since October 1—one might be inclined to think it’s not so hot. And it isn’t. That’s 180,000 or so a month, and if you post that number against the stated goal of 7 million by next spring, the stated goal looks awfully chimerical, and the thing seems a disaster (180,000 times six months, the enrollment period, is just 1.08 million).
Dig a little deeper and things look considerably better. If we could graph it, the bar line of enrollment would make for a pretty impressive ski slope: After just 27,000 people signed up in the whole of October, The New York Times reported over the weekend, about 100,000 people signed up in November, and then, in the first week of December alone, 112,000 chose plans. The Los Angeles Times put out slightly different numbers Wednesday but agreed on the trend. From an obviously atrocious starting place, enrollment is essentially quadrupling. If that pace were to continue, the 7 million figure would be cleared in March.
I still wouldn’t quite bet on that. But I would definitely and unflinchingly bet on the central proposition I argued last week: By next fall, HealthCare.gov is going to be a net plus for Obama and the Democrats.
Wishful thinking? You can call it that if you want to. But I warn you I’m not usually a wishful thinker. Like most partisans on either side, I tend to expect the worst. It’s usually a wise insurance policy; you’re rarely disappointed. I write such things only when I really think them, like the time in August 2012 when I wrote a column suggesting that Obama could very well win about 330 electoral votes. He won 332, which most anyone else would have said when I wrote that piece was crazy.
I had a hunch then, and I have one now. And my bet is based on a lot more than enrollment numbers. It’s based on the numbers of people who are benefiting and will benefit from aspects of the law. These aren’t in the thousands. They’re in the millions. About 70 million citizens will enjoy free—free—preventive care for a range of services that typically weren’t covered at all before or at best were covered and required a co-pay. About half of them are Medicare recipients (= old people = voters). Preventive care, as you may know, is something our system hasn’t been doing very well. Now it will.
More than 100 million Americans live with what the insurance companies would define as pre-existing conditions. Over these next few months, as their symptoms flare up or especially if they worsen, requiring lengthy hospital stays and intense treatment, they’re going to be seeing that they don’t have to fret about money or whether they’re going to continue to be covered anymore. Mental-health coverage is going to be improved dramatically for up to 60 million Americans. Nearly 7 million senior citizens are going to find in the coming months that they’re no longer screwed by the doughnut-hole prescription-drug problem that was created by the Bush Medicare Part D law of 2003 and corrected by Obamacare. It is saving these 7 million seniors an average of $1,000 a year, which for many of these folks is probably a reasonable chunk of their income.
I could go on. The thing is that all this isn’t going to make the papers and the cable channels much. There isn’t a lot of inherent news value in a free cervical-cancer screening or a prescription-drug refill. But these millions of people live real lives, not on TV, and they and their families and friends will know what has happened.
You see that I’m not making a Beltway/political argument. Washington, D.C., will, I can promise you, be the last city in the United States to change its mind about Obamacare. Once a notion becomes conventional wisdom in this town and rocks a president’s poll numbers the way the disastrous rollout so clearly has, it takes a typhoon to dislodge it. Or a hurricane—remember how Karl Rove was making the United States a conservative country until Katrina came along and sent Bush’s approval numbers down there in the range of curdled milk?
The rollout won’t be a hurricane. It will be a calm rain, a steady shower of reality across the country that may never achieve quite enough force to trump inside-the-Beltway perception but will be strong enough to change many people’s minds around the country.
Fixes still need to be made. But now, as opposed to a month ago, one can feel as if they will be made. And without excusing the bollixing up of the rollout, of which I’ve written very critically, one can also say now that in historical context, this is all happening pretty fast. Remember, the original Social Security legislation was passed in 1935. And when did the first check go out? Not until 1940. Can you imagine a five-year lag in today’s media world? Roosevelt, and more important the program itself, would have been torn to pieces. I think in two more years’ time, and indeed less than that, many millions of Americans will see that what they thought was decent health insurance before the Affordable Care Act was like gaslight before electricity. If that’s wishful thinking, it’s for their sake, not the president’s.
By: Michael Tomasky, The Daily Beast, December 12, 2013
“Running Out Of Fresh Attacks”: Republicans Revive Mitt Romney’s Favorite Medicare Attack
With HealthCare.gov substantially improved and new insurance signups surging, Republicans have been forced to pivot to a new line of attack against the Affordable Care Act. On Tuesday, the National Republican Senatorial Committee issued a series of news releases accusing Democratic candidates of cutting Medicare through their support of the health care reform law.
“As the ObamaCare disaster continues to unfold, Mark Pryor and National Democrats have resorted to deceiving seniors using their old and discredited MediScare playbook,” reads the release targeting Senator Mark Pryor (D-AR).
“What’s new this year is the blatant hypocrisy that Mark Pryor and his liberal allies in Washington are exhibiting,” it continues. “Pryor’s deciding vote for ObamaCare cut $717 billion from Medicare—including nearly $5.4 billion directly from Arkansas ($10,296 per Medicare recipient in Arkansas).”
CNN reports that the NRSC campaign will target Senators Pryor, Mark Begich (D-AK), Kay Hagan (D-NC), Mary Landrieu (D-LA), Mark Udall (D-CO), Tom Udall (D-NM), Dick Durbin (D-IL), Jeanne Shaheen (D-NH), Jeff Merkley (D-OR), and Al Franken (D-MN), along with Senate candidates Rep. Bruce Braley (D-IA) and Rep. Gary Peters (D-MI).
If this line of attack sounds familiar, it’s because it was a centerpiece of Mitt Romney and Paul Ryan’s case against the Affordable Care Act in the 2012 elections. The Republican ticket repeatedly accused President Obama of having “robbed” and “raided” $716 billion from Medicare to “pay for Obamacare, a risky, unproven, federal takeover of health care.”
Of course, that attack ignored the fact that the overwhelming majority of the $716 billion actually represented reductions in how much Medicare pays hospitals and insurers, as WonkBlog’s Sarah Kliff explained last August. Medicare benefits themselves are not affected.
It also ignored the fact that Ryan’s own budget included the exact same $716 billion in cuts (with the implied promise of deeper cuts in the future to pay for trillions of dollars in new defense spending and tax cuts). He has also kept the savings in subsequent budget proposals. Nearly every Republican in Congress — including Rep. Tom Cotton (R-AR), Pryor’s chief rival in his 2014 re-election bid — has supported Ryan’s budget plans, significantly blunting the accusation’s impact.
Nonetheless, House Speaker John Boehner’s (R-OH) spokesman Brendan Buck told MSNBC that the attack is “a tried and true campaign hit” — ignoring that it totally failed to blunt the Democratic Party’s sweeping victory in 2012.
There’s no denying that Republicans had a good political month targeting the Affordable Care Act’s rocky rollout. But the fact that they are already returning to this easily debunked attack, which was proven to be unpersuasive in the last election, raises the question of whether they are running out of fresh attacks against the law. And with repeal seemingly off the table, one wonders where Republicans will turn if good news about the law continues to trickle out.
By: Henry Decker, Featured Post, The National Memo, December 4, 2013
“Kicked To The Curb”: Republicans’ Self-Hatred Swells To The GOP Vs. Its Own Base
Does any modern political party besides the GOP hold a huge segment of its base in contempt? I’ve written a lot about how Republicans have failed to make inroads with Latinos, young voters or women since their 2012 defeat, but what’s really interesting is the way they continue to deride many of their older, white, working-class voters, too.
When Mitt Romney insulted “the 47 percent” of Americans who pay no federal income taxes, he failed to notice that the vast majority of them are white, most of them white seniors, the most reliably Republican voters in the country. A large portion of the people Paul Ryan describes as “takers” – vs. productive “makers” – are likewise older whites. And although Ryan and his party want to turn Medicare into a voucher program – run by exchanges, much like the Affordable Care Act – they tried to hide that fact during the 2012 race because it was hugely unpopular with their base.
The latest insult came from former senator and 2012 presidential runner-up Rick Santorum. On CNN’s “State of the Union” Sunday Santorum complained that the Affordable Care Act has meant that “sicker, older” people are getting health insurance (h/t Crooks and Liars.) Santorum told Candy Crowley and former Gov. Howard Dean:
Well, let me just add that one of the solutions that President Obama tried to accomplish was to let people keep their own insurance. It turns out that a lot of insurance companies are actually allowing that to happen, and that could cause even more problems for Obamacare, because that means fewer and fewer people getting into the exchanges. And the ones who, at least to date, it’s just facts Gov. Dean, the ones in the system are much older.
I talked to one insurance company today, a third of their enrollees are over sixty years of age. That is not how an insurance system would work, but those are the people signing up and the folks who can keep their plans because they’re more customized and lower cost, will now. And the folks who are going to get into these exchanges are going to be probably sicker, older, and as a result, premiums are even going to go higher.
First of all, it’s not clear Santorum is right about this. Some states are seeing unexpectedly high proportions of younger people sign up for coverage. In Kentucky, 41 percent have been under 35; in California, it’s 22 percent, which is proportionate to their share of the population. Still, the enrollment rate in California is highest for people over 55. That’s not surprising, or permanent: Based on the experience of Massachusetts, older people tend to sign up for coverage first; younger enrollees do it closer to the deadline.
But assuming that Santorum isn’t wrong (admittedly a leap), what is he saying? That people over 60 who don’t have coverage shouldn’t be able to get it? We know these people are white, and presumably – since they’re not eligible for Medicaid, which covers many of the poor and unemployed — they’re working people. But Santorum says “that’s not how an insurance system should work.”
Luckily Howard Dean was there to disagree. “I think it’s great that we’re insuring people who can’t get insurance that are over 55 and 60,” he told Santorum and Crowley. “That’s what this is supposed to do.”
Of course, if insurers are unhappy with their older customers, Rep. Alan Grayson has an answer: his “Medicare for All” bill, which would allow anyone who wanted to to sign up for Medicare instead of a private insurance plan. Back during the ACA debate many liberals wanted to see that option, but it was vetoed by insurance interests. Opening up Medicare to people 55 and older would help stabilize the program – although they’re the older edge of the ACA pool, they’d be younger and healthier subscribers in the Medicare pool – and provide an alternative for those priced out of or under-served by the private market.
Still, the big news this weekend was that the federal website that lets most people access insurance exchanges, Healthcare.gov, is mostly fixed. That’s why Santorum was reduced to railing against those takers in the GOP base. On Fox News Sunday, Chris Wallace attacked the ACA as “income redistribution.”
And, of course, Santorum insisted that the ACA’s troubles raised questions about “the president’s competence.” Dean wasn’t having that either.
“That’s right-wing talking points against this president,” Dean replied. “From day one, they’ve tried to undermine him as a human being … I lose my patience with this nonsense. I do believe that the facts are going to be determined by what happens on the ground. Three months from now, a lot more people are going to have health insurance, and a lot more people are going to be happy with all this.”
By: Joan Walsh, Editor at Large, Salon, December 2, 2013
“Throwing Their Own Under The Bus”: CEO’s With Massive Retirement Fortunes Push Social Security Cuts
With budget negotiations on the horizon, a buzz is building around Social Security, from Elizabeth Warren and other Democrats calling for an expansion of benefits to The Washington Post arguing that seniors must be sacrificed for the good of the “poor young.”
Two of the biggest players in the debate are largely behind the scenes: Business Roundtable and Fix the Debt, corporate lobbies that use deficit fear-mongering to sell benefit cuts. These groups are made up of CEOs of America’s largest corporations—people with retirement accounts that are more than 1,000 times as large as those of the average Social Security beneficiary.
Each of the 200 executives of Business Roundtable has retirement savings averaging $14.5 million, according to a new report from the Institute for Policy Studies and the Center for Effective Government. That’s compared to the $12,000 that the median US worker near retirement age has managed to put away. Once Business Roundtable CEOs start drawing Social Security themselves, they’ll be cashing a monthly check that is sixty-eight times larger than an ordinary retiree’s, ensuring that they’ll never bear the burden of the cuts they’re advocating.
“I find it hypocritical to see CEOs sitting on massive retirement fortunes of their own saying that the solution to the country’s fiscal challenge is to put an even greater burden on retirees, many of whom already struggling,” said Sarah Anderson, director of the Global Economy Project at IPS and one of the report’s authors.
One of those CEOs is David Cote, the vice-chair of Business Roundtable and a member of the steering committee for Fix the Debt. After eleven years at Honeywell where he’s now the chief executive, his retirement assets are worth $134.5 million. That means that as a retiree he’ll draw a monthly pension of nearly $800,000.
Cote is a deficit hawk, and claims to be worried about the long-term stability of Social Security. A member of the Bowles-Simpson commission and President Obama’s debt committee, Cote has called for $3 to $4 trillion in spending cuts over the next decade, “especially when it comes to entitlements.”
To make some of those reductions via cuts to Social Security, Business Roundtable has proposed raising the retirement age to 70, restricting benefit growth and changing the way inflation is calculated in a way that amounts to a benefit cut for seniors. (Read George Zornick on why this change, called Chained CPI, is a bad deal.) At the same time, Business Roundtable and Fix the Debt are calling for more corporate tax breaks.
“If Congress approves of proposals like ones that Business Roundtable are pushing, we could see severe cuts that could mean the difference between any kind of dignified retirement and absolute poverty,” Anderson said. Two-thirds of retired Americans rely on Social Security for the majority of their income, and more than 40 percent would be in poverty without those benefits.
These CEOs aren’t just trying to short the average American retiree; they’re throwing their own under the bus. While raising alarm about the federal debt, Business Roundtable CEOs have run up massive deficits in their employees’ pension funds. According to the report, ten companies led by members of Business Roundtable have shortfalls in their employee pension funds of between $4.9 and $22.6 billion. The largest of those belongs to General Electric, run by Business Roundtable and Fix the Debt member Jeffrey Immelt, the prospective beneficiary of a $59.3 million retirement fund.
GE stopped offering traditional pension plans for new employees in 2011, forcing workers to switch to 401(k) plans. Many other companies have shifted the burden of retirement savings to their employees in this way in recent years, and that’s been a significant driver of the retirement crisis. Just 18 percent of workers can expect traditional pensions today, compared with 38 percent in 1985. Instead of getting a fixed check, retirees are at the mercy of the market—making the assurance of Social Security benefits even more essential. But Business Roundtable continues to put the responsibility for the retirement crisis on retirees themselves. “[T]rue retirement security will be achieved only if Americans save more,” reads the group’s 2013 CEO Growth Agenda.
Saving more is an increasingly unworkable solution for the millions of workers whose wages and benefits are being undercut by some of the same CEOs directing them to do so. As the report lays out, many of the most effective ways to strengthen Social Security involve asking more of executives, not employees. Eliminating the cap on wages subject to Social Security taxes (currently set at $113,700) would eliminate 95 percent of the projected shortfall for seventy-five years, according to the Congressional Research Service. That’s three times the deficit reduction achieved by raising the retirement age to 70. Subjecting stock-based compensation to Social Security taxes would raise billions more.
Don’t expect to hear about those proposals from Business Roundtable, however. “I do think that it is a real weakness of these corporate lobby groups, that they’re making the public face of the agenda to cut Social Security these CEOs that are sitting on massive nest eggs of their own,” said Anderson. “It undercuts their credibility and influence in these debates, and I’m hoping it will make it difficult to achieve the cuts they’re proposing.”
By: Zoe Carpenter, The Nation, November 19, 2013
“Where Is The Love?”: Compassion Isn’t A Sign Of Weakness, But A Mark Of Civilization
When I’ve written recently about food stamp recipients, the uninsured and prison inmates, I’ve had plenty of pushback from readers.
A reader named Keith reflected a coruscating chorus when he protested: “If kids are going hungry, it is because of the parents not upholding their responsibilities.”
A reader in Washington bluntly suggested taking children from parents and putting them in orphanages.
Jim asked: “Why should I have to subsidize someone else’s child? How about personal responsibility? If you procreate, you provide.”
After a recent column about an uninsured man who delayed seeing a doctor about a condition that turned out to be colon cancer, many readers noted that he is a lifelong smoker and said he had it coming.
“What kind of a lame brain doofus is this guy?” one reader asked. “And like it’s our fault that he couldn’t afford to have himself checked out?”
Such scorn seems widespread, based on the comments I get on my blog and Facebook page — as well as on polling and on government policy. At root, these attitudes reflect a profound lack of empathy.
A Princeton University psychology professor, Susan Fiske, has found that when research subjects hooked up to neuro-imaging machines look at photos of the poor and homeless, their brains often react as if they are seeing things, not people. Her analysis suggests that Americans sometimes react to poverty not with sympathy but with revulsion.
So, on Thanksgiving, maybe we need a conversation about empathy for fellow humans in distress.
Let’s acknowledge one point made by these modern social Darwinists: It’s true that some people in poverty do suffer in part because of irresponsible behavior, from abuse of narcotics to criminality to laziness at school or jobs. But remember also that many of today’s poor are small children who have done nothing wrong.
Some 45 percent of food stamp recipients are children, for example. Do we really think that kids should go hungry if they have criminal parents? Should a little boy not get a curved spine treated properly because his dad is a deadbeat? Should a girl not be able to go to preschool because her mom is an alcoholic?
Successful people tend to see in themselves a simple narrative: You study hard, work long hours, obey the law and create your own good fortune. Well, yes. That often works fine in middle-class families.
But if you’re conceived by a teenage mom who drinks during pregnancy so that you’re born with fetal alcohol effects, the odds are overwhelmingly stacked against you from before birth. You’ll perhaps never get traction.
Likewise, if you’re born in a high-poverty neighborhood to a stressed-out single mom who doesn’t read to you and slaps you more than hugs you, you’ll face a huge handicap. One University of Minnesota study found that the kind of parenting a child receives in the first 3.5 years is a better predictor of high school graduation than I.Q.
All this helps explain why one of the strongest determinants of ending up poor is being born poor. As Warren Buffett puts it, our life outcomes often depend on the “ovarian lottery.” Sure, some people transcend their circumstances, but it’s callous for those born on second or third base to denounce the poor for failing to hit home runs.
John Rawls, the brilliant 20th-century philosopher, argued for a society that seems fair if we consider it from behind a “veil of ignorance” — meaning we don’t know whether we’ll be born to an investment banker or a teenage mom, in a leafy suburb or a gang-ridden inner city, healthy or disabled, smart or struggling, privileged or disadvantaged. That’s a shrewd analytical tool — and who among us would argue for food stamp cuts if we thought we might be among the hungry children?
As we celebrate Thanksgiving, let’s remember that the difference between being surrounded by a loving family or being homeless on the street is determined not just by our own level of virtue or self-discipline, but also by an inextricable mix of luck, biography, brain chemistry and genetics.
For those who are well-off, it may be easier to castigate the irresponsibility of the poor than to recognize that success in life is a reflection not only of enterprise and willpower, but also of random chance and early upbringing.
Low-income Americans, who actually encounter the needy in daily life, understand this complexity and respond with empathy. Researchers say that’s why the poorest 20 percent of Americans donate more to charity, as a fraction of their incomes, than the richest 20 percent. Meet those who need help, especially children, and you become less judgmental and more compassionate.
And compassion isn’t a sign of weakness, but a mark of civilization.
By: Nicholas D. Kristof, Op-Ed Columnist, The New York Times, November 27, 2013
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